vote:

the presiding officer: are there any members wishing to vote or dhaing their vote? if not, on this can yeas are 99, the nays are zero. three-fifths of the senators duly chosen and sworn having vote fed the affirmative, the

motion is agreed to. a senator: mr. president? the presiding officer: the senator from oklahoma. mr. coburn: i wanted to spend a little bit of time offering a viewpoint different than the chairman of the committee on

this bill. first of all, i want to say by context, my father and two brothers served in world war ii, my brothers during the vietnam era. there is no question we have an obligation to meet our commitments to those that have put their life and future on the line for this country. but it pains me that although we've increased spending 58% in the v.a. program since 2009, which is fiscal 2010, what we have seen is a complete lack of oversight of what's happening. let me give you an example. the v.a. community in the senate -- committee in the senate last year held 30

hearings, four of which were oversight. if you read the transcripts, you cannot call them oversight hearings, even though they were billed as oversight hearings. why is that important? it's important because there's a multitude of significant, serious problems in the veterans administration. just two ties daisuke ago -- days ago, it's discovered in an l.a. v.a. colin pick, the staff destroyed the records of thousands of people so when they do the metric on how far behind, we can't measure it. or the fact that 82 veterans last year died of carcinomas through delayed diagnose it's because they couldn't get a diagnostic procedure like a colonoscopy. or the fact that we have all these veterans that cannot access mental health care and we see the suicide rate

unacceptable to say the least. so we have a bill on the floor that massively -- and that is a small word for what this bill does -- massively expands the authority and the ability of the v.a. to offer care to another 14,000 -- 14 million, pardon me -- veterans. from six million to 20 million. on a system today that can't keep up, we have 600,000 people waiting for a disability determination, we're not having oversight hearings on that. we're not having oversight hearings on south carolina v.a. hospital where people are dying through malpractice like crazy. we're not having the oversight hearings to hold the v.a. accountable. what we're doing is putting a bill to expand their responsibilities instead of holding them accountable for the responsibilities they have

today. that's what we should be doing. and instead we're going to add $60 billion -- that's a conservative number, that's my number, but all you have to do is looking at what the cost and the efficiency and the outcomes are through the v.a. system to see. we're going to diminish the veterans caregiver program by expanding it to everybody. we're going to create all sorts of new programs and no resources to actually provide it. and we're going to create more advanced funding, advanced appropriations which will limit our ability to hold them culpable in the future. there's a lot of things we ought to be doing for our veterans right now, that's already in law that we're not doing. and we come to the floor with a massive expansion at a time when

we can't even care for what we're doing. and as a physician who trained in v.a. hospitals, i know the difference in the level of care. and i can assure you it's not gotten any better. and for my colleagues i speak to in the medical profession and from the veterans that i talk to that contact me, it's gotten far worse. it doesn't have to be that way. but it will always be that way if, in fact, we continue to not hold those in leadership positions accountable for not stepping up to the bar of performance, quality, and outcome. from congress to the pentagon we must reassess what laws, regulations and rules can be changed to ensure that benefits and other decisions veterans' affairs makes are beyond reproach and based on the best facts available. let's ensure that the department's limited resources

are focused on its core mission rather than dispersed in an effort to remedy every possible problem for every veteran. remember, when everyone is first priority, no one is. that's what this bill is. we diminish the priority of the commitments that we have made to the veterans that are out there today. our veterans are looking for us for help. we're about to enact legislation that's going to further strain the ability of the v.a. to do their most basic charge, help with the health care, mental health, and capability of those that have put it all on the line for this country.

it's shameful that congress now is trying to claim credit for providing new benefits while our old promises are forgotten. and our heroes, our heroes, are literally dying at the hands of malpractice, incompetency, and delay. if we really wanted to care for our veterans, those with service-connected disabilities, what we'd say is go wherever you want to go to get whatever you need because you served this country and it actually would cost less. but because we pile them into a broken system now -- and that's not all v.a. organized, let me clarify that. there are some excellent v.a. hospitals that do great work. their specialists are far ahead

of the private sector. but on general grounds, to put a veteran at a place less than the best possible care dishonors their service to this country. dishonors their service to our country. veterans are our heroes. they're the symbol of our country of sacrifice, of giving for others, and yet we have four oversight hearings in a year with a multitude of problems that are going on in the v.a. hospitals and the v.a. administration in terms of disability determination. we have four? the house had 34 overt hearings and they were -- oversight hearings and they were rigorous. when you ask members of the committee have you head the

house oversight hearings, no. so they had 26 regular hearings and 2434 oversight hearings trying to hold the v.a. accountable. we're not going to hold the v.a. accountable with this bill. we're going to make them less accountable. that's a disservice to the very people that honored us by serving in the military of this country. as of february 15, 2014, the v.a. has 677,000 claims pending for disability compensation. why should it take a year for somebody who put their butt on the line for this country and received an injury and is disabled pour it, why should it take a year for us to determine that we owe them an extra bit of

suspension and availability? what's being done to fix that? we have the v.a. regional center in my hometown, good employees. hardworking employees. they're not destroying files so they can say they met a metric. veterans seeking mental health treatment still experience weeks' long delay scheduling appointments and the epidemic of overprescription of opiates -- let me say that again. there is an epidemic of overprescription of opiates for those people who served our country, making them dependent addicts because we give them the wrong treatments. there's avoidable veterans' deaths at the v.a.

a recent story by cnn misdiagnosis and improper care -- just gastrointestinal conditions. two-year consultation delays. two years? to get in to see a specialist at the v.a. when you're losing blood? how do we explain that? who's accountable? we are. because we're not holding them accountable. 82 deaths last year alone, and i'm sure that's a far understatement, because of delayed diagnosis for just investigative endoze endoscopie. that's just what's documented. how do we accept that? because had they been in the private system, they wouldn't have had a delay. they wouldn't be dead.

so here's the proposal that i would put out: do our veterans deserve the best of care in this country? i think they do. should they be able to get that care where they know the quality, they know the outcomes and transparency as to what their future might be? or must they be forced into a system that's going to give them something less than that? because that's where we are today. the chairman in his mark increases v.a. medical care for everybody that served, without a disability. what will that do? -- what will that do to the v.a.

system? we can't handle what we have in front of us now in terms of those that have a percentage medical disability that allows them access to the v.a. health care system. so when you triple that -- or, more than triple it, where are the resources? and if we really mean what we say in this bill, you're talking hundreds of billions of dollars over ten years. you're not talking the $30 billion that the chairman says is what the cost is. you're talking hundreds of billions. but the point i would make is we have an infrastructure out there that can care for our veterans. it's the hospitals all around the country. i.t. thit's the doctors all aroe cufnlcountry. does a veteran not deserve to get the best care?

shall we give them a card that says, you served this country. here, you can get care at a v.a. hospital if you want or you can get care where ever whereever y. if we give what was promised to the veterans, not what we're giving today -- real care, real transparency as to outcome, what you'll see is marked improvement in care, marked improvement in outcomes, no change in additional cost, no change in additional cost, and access that's promised but not denied and delayed. in one south carolina v.a. facility alone, 20 veterans are either dead or dying of cancer

because of delayed diagnosis. had the symptoms, presented to the hospital, but because of delay and incompetency -- just that one hospital. the other thing we know is veterans' malpractice claims are markedly increasing -- markedly. all you have to do is look at the o.i.g. report on the claims of deficiencies at the v.a. in new haven, connecticut. contamination, cross-contamination, inadequate procedures for infectious -- infection precautions, absence

of employees that are supposed to be on duty when they're not, failure to clean operating rooms properly, failure to have the proper ventilation system in an operating room for a contaminated case. that's just one hospital. what does that mean in real life? what that means in real life is the risk for an iatrogenic or physician-caused physician goes through the roof. not the fault of the physician. the fault of the v.a. for that the managing the system properly. former v.a. epidemiologist dr. steven coughlin testified before the house veterans health affairs committee that the v.a. failed to follow up on almost 2,000 veterans who indicated in v.a. surveys that they were experiencing suicidal thoughts.

when the hvac followed up, dr. coughlin's claims, they found that they were validated. and, unfortunately, too many of those who had suggested their problems committed suicide. it is a little late. because dr. coughlin brought this up, who was admonished, bullied and intim datad for speaking -- and intimidated for speaking about the ethical lapses at the v.a. where's the oversight hearing on that here? you see, if we're not going to hold the v.a. accountable, the quality of care isn't going to rise to the level that our veterans deserve.

other areas -- the v.a. wasted $3 billion over the past ten years because they failed to secure competitive market prices for surgical implants. that's $3 billion. that's documented. that's a g.a.o. study showing it. g.a.o. did that. we didn't do it. we didn't find it. and, oh, by the way, at the end of the year when they had some money to spend, they bought $600,000 worth of artwork instead of putting it into additional doctors, cleaning operating rooms, additional people to secure clearances on disability.

one of the things, by expanding care to the potential of 22 million veterans, is that you can guarantee that the veterans are getting care now, are going to get poorer quality and less access to care. you can guarantee that. so that's what this bill is really about. this bill is really about a decrease in the requirements for care for our veterans. it's not about an increase. it's about a decrease, because when you flood that system with people who do not have a service-connected disability, what'll happen is easy goes first, hard goes last. seen it in the v.a. my whole life.

there's also an expansion in the caregivers' program. i am ape not sure i disagree with -- i'm not sure i disagree with it. but certainly for those after 9/11, the commitment ought to not be diminished if we expand this program. the minimum cost for that is $9.5 billion. and v.a. has not yet met its full obligation under the v.a. caregivers' law that we have today. yet we're not holding them accountable for that. there's another area of this bill that i think is tragic. it's well-intended, but to mandate that the -- that the

university of west virginia or the university of oklahoma must give in-state tuition to anybody from anywhere that's ever served or they lose their benefits under the g.i. bill totally ignores the constitution in this country. now, 20 states have already said they're doing that. ten others have bills in the process. eight others have a partial. so we're at 38 of the 50 states right now. but in our vision we're going to mandate that the 10th amendment doesn't mean anything, that the 80% of funding on the higher education that comes from the people in the state of oklahoma, we can coopt that and tell them what they're going to do. it's well-intended. but it's certainly not constitutional. and it certainly doesn't respect the 10th amendment of the united states. does oklahoma or west virginia have the right to make a decision on who they give

in-state tuition? why not just pass a law that says every state will give in-state tuition to everybody? the reason it was connected with state is because of state funding. we totally trample that. and, again, the advantaged appropriations will -- the advanced appropriations will limit our ability to hold those people accoun accountable for ty things i've described here. but we're going to do it anyway. a proposal to expand v.a. advanced appropriation needs to be considered by the administration as part of an across-the-government review of the advantages not only for the v.a. but also for other programs and agencies. only in such a broad context should the administration offer such a position on the v.a. therefore we cannot make an

opinion. that's from the v.a. the real answer is, give us advanced appropriations and then only after the fact can you hold us accountable. not during the fact. here's another g.a.o. study that we should be highly concerned about. the v.a. -- this is the g.a.o. -- has no idea how long most patients wait to receive care. they don't even know their own metrics. it's unclear how long veterans are waiting to receive care in v.a. tion medica's medical facis because the reported data are unreliable because v.a. hospitals have tried to fudge. where's the oversight hearing on that? or the l.a. -- they just destroyed medical records, nobody can knee how long people

have been waiting for appointments. based on g.a.o. recommendations to improve reliability of reported wait times for new medical appointments in 2013, the v.a. changed the way it tracks and calculates its performances. using the new tracking method in 2013, the v.a. reported only 41% of veterans were scheduled for a new primary care appointment and only 40% of veterans were scheduled for a new experiment appointment within the 14-day standard. so 40% of the time with the 6 million veterans we have now are getting adequate, timely care. 60% are not and we're going to expand that to 22 million? and we don't have the resource base or the facility base or the employee base or the

professional base or the caregiver base to do that? in contrast, the 2012 v.a. reported that 90% of new primary care appointments and 90% of specialty appointments had met the 14-day standard. the v.a. request backlog purge. v.a. employees destroy medical records to cancel backlog exam request. that's from patrick haley again. oliver mitchell, a marine veteran and former patient services assistant at the los angeles v.a. system told the "daily caller" we just didn't have the resources to conduct all those exams. basically we would get 3,000 requests a month for medical exams but in a 30-day period we only had the resources to do

about 800." that's 25 a day. that rolls over to the next month and creates a backlog. it's a numbers thing. the waiting list counts against the hospital's efficiency. longer the veteran waits for an exam, it counts against the hospital as far as productivity is concerned. some patients were waiting six to nine months for an exam. and the v.a. didn't know how to address the issue." is the answer to open this up to another 16 million veterans? or is the answer to improve the efficiency, transparency, quality and outcomes of the present v.a. system before we go about expanding this system to people who are otherwise covered? mr. mitchell, when he tried to sound the alarm on the v.a.'s deliberate attempt to fraudulently reduce the backlog, he was transferred out of his department and eventually terminated from his job. after he contacted congress in

2011, two months later when the v.a. found out about it, he was fired. so do we really want transparency in what we're doing? do we really want to know what's going on? do we really want to fix the system? do we really want to offer health care to veterans? and make it equal to what they can get in the private sector? or do we want to say we want to offer all these new benefits at the same time we're not meeting our commitment on the benefits that we've already promised. that's the game that's being played. and earlier i said the v.a. senate committee on veterans' affairs held 30 hearings. they only held 16, 16 hearings. one every three weeks. the annual budget of the

department of veterans affairs exceeds $134 billion a year. delays in vet care is not for the lack of money. the delays in vet care is not for the lack of money. it's for the lack of accountability management. case in point. more than 20 veterans have died or dying due to late diagnosis treatment of cancer due bryant medical center in columbia, south carolina. documents see that only a third of that $1 million appropriated by congress to fix the problem was used for its intended purpose at that v.a. facility. only a third of the money that we appropriated to fix this problem was actually used for it. to pay for care for veterans on waiting lists. at the same time the documents show the waiting list at dorn kept growing to 3,800 patients in december of 2011.

mr. president, i'll be back to speak on the floor and offer amendments. i have pages and pages of examples of veterans who served this country honorably, proudly and sacrificed to a great extent who are getting substandard care in the system that we are offering them today. before we expand that system, what is needed is a ru rigorous oversight and debate about how we're doing what we're doing now. the promise of access to care by our veterans -- to our veterans

shown from v.a. centers to clinics all across this country, hospitals all across this country, diagnostic procedures all over this country, the promise of access, when access is delayed, that's care denied. and that's what's happening right now. far too often. to the people who have served this country. we ought to be about fixing that and holding accountable those in the responsible positions and holding ourselves accountable to do what is necessary to give at least the standard of care that they could get anywhere else in the country. it's time that's the direction we should go. so i thank the president for the time, and i yield the floor.

mr. sanders: mr. president? the presiding officer: the senator from vermont. mr. sanders: i look forward to discussing in the next several days the issues that senator coburn raised but i did want to make one clarification. i hope the senator is listening. he repeatedly indicated that this legislation opens the door to every one of the 22 million veterans in america and then proceeded to say that once you open the door, you're going to have inadequate care because we don't have the resources to take care of 22 million veterans. that simply is inadequate, inaccurate, and that is not in the legislation. there's nothing in the legislation that says we open the door to every veteran in america, regardless of income. so when people talk about the v.a. suddenly be flooded by

veterans and care being diminished because of the huge increase into the system, that is just not true. what is true? what is true right now is we have an absurd and complicated income eligibility system throughout this country. so what happens in the state of vermont or the state of california, your eligibility for the v.a. if you are a priority eight is different and dependent upon the county in which you live. so in vermont, you can be living in a county where if your income level is $45,000 a year, you are eligible for v.a. health care, but in a county across the street where the line is across the street, you may not be eligible.

and in states like california or georgia, which have many, many, many counties, you have an absurd situation where a person living on one side of the street is eligible for v.a. health care, a person living on the other side of the street is not eligible for v.a. health care. this is totally absurd. we end up having hundreds and hundreds and hundreds of different income eligibility standards. what this legislation does is not open the door -- and i hope my republican colleagues will not i continue to say it because it's just not true -- what it does do is say that in a state where you have different income eligibility standards based on counties, what we will do is have one income eligibility standard per state, that being the highest level. so you'll have 50 different standards -- 50 different

standards for 50 different states, not have hundreds and hundreds and hundreds of different standards. but in every state there will be an income eligibility level. it will not open the door for health care to 22 million veterans. second of all, we were very careful in this legislation to say that if a veteran who under this bill would be eligible for v.a. health care, a veteran who can newly access v.a. health care, we absolutely have to have the medical infrastructure available so that all veterans will get the quality care that they need, that new veterans coming in will not diminish service for other veterans. and in this bill we make clea clear -- and we made clear in

this with our long discussed with the disabled american veterans -- that the priority for the v.a. remains those veterans who were injured in action, those veterans who need that care. that is the highest priority that we establish. so when people say we're opening the door to all veterans, care is going to be diminished, that simply is not true. that is not what the bill says. second of all, let me reiterate some of the provisions that are in this bill. because before we vote on final passage -- and, by the way, i want to take this opportunity to thank every member of the senate for voting to proceed. i think it is time that we had some very serious debates about v.a. health care. now is the time to do it.

but let me reiterate a point i made earlier. senator coburn raised important issues. senator burr before him raised important issues. we should debate those issues. but in all due respect for the veterans of this country who have sacrificed so much, let us not politicize this debate on veterans' issues by bringing in sanctions against iran or let's not bring in obamacare, let's not bring in the dozens of other issues that are out there. let us debate this issue on its merits. let us bring forth amendments which deal with veterans' issues. senator coburn, senator burr have amendments which deal with veterans' issues. i welcome those amendments. let's have those debates. nobody ever suggested that this bill is perfect. there are a lot of senators out

there, democrats and republica republicans, that have ideas about how we can improve the services and the programs we provide to veterans. i welcome those ideas. but do not destroy this legislation by politicizing it, by doing what we have done month after month, year after year which is why the american people have so much contempt for what goes on in congressmen congress. let us focus on veterans' issues. we have differences of opinion. let us debate those issues. let us not bring in extraneous matters, poison pills which will give people a reason to vote against this bill. let's debate veterans' issues. and let me talk about some of the issues in this bill that my republican colleagues did not talk about. number one, i am proud -- i hope that we're all proud -- that

recently we made sure that the promises made to military retirees were kept, that we rescinded the cola decrease, the 1% cola decrease that was in the bipartisan budget agreement. but we did not go far enough. men and women who are joining the military after january 2014 are still subject to that decrease in cola. are we in favor of keeping promises to all veterans, including the new members of the armed forces, or are we not? let us debate that issue. i believe that we keep our promises to all veterans. that is in the bill. people want to oppose that? they have the right to oppose that. we have heard in several instances that the v.a. does not have the medical infrastructure to take care of the needs of veterans and that is true, and

that is why in this bill we authorize v.a. to enter into 27 major medical facility leases in 18 states and in puerto rico. 18 states and puerto rico. so you can't come forward and say, gee, v.a. does not have the infrastructure to take care of veterans' needs but then vote against a provision which significantly expands v.a. health care capabilities. now, i talked a moment ago about what we mean by expanding v.a. health care. we do away with the absurdly complicated bureaucratic situation that now exists in which there are hundreds and hundreds of different income eligibility standards in 50 states in the country. we reduce that to 50. in california, you will know whether you are he eligible for v.a. health care as a priority 8

veteran or not. that is true in vermont as well. does it open the opportunity for more veterans to come into v.a. health care? it does. and the reason for that is that v.a. provides good quality health care to our veterans, and that is why the veterans throughout this country that i have talked to and in patient satisfaction surveys are very approval and supportive of the v.a. health care. more want to come into the system. we have heard just how terrible and awful v.a. health care is. and then we have heard we don't want to open the doors because it's going to be flooded with new people coming into v.a. health care. you can't have it both ways. if v.a. health care is so terrible, is so bad, why are you atrade of new people coming into v.a. health care? the answer is if you go out to the v.a. community, to the veterans community, what they will tell you is, yeah, there are problems in v.a. there is a problem in every

health care institution in this country. over 30,000 americans die every single year because they don't get to the doctor when they should because they don't have health care. i don't want any veterans to be part of that number. hospitals all over this country are struggling with an epidemic of infections, and in fact the v.a. has done quite good, better than many other medical institutions in addressing that. in terms of telehealth, which is so important to veterans in my state, in my rural state and in rural states all over the country, guess, mr. president, which medical institution is leading the country in terms of telehealth. it's the veterans administration. that means that a veteran can walk into a v.a. community-based outreach clinic in rural west virginia and get on to a

teleconference with specialist in any other part of the country. v.a. has been cutting edge in terms of telehealth. we talk about medical technology and medical health care records. guess which health care institution in america has led the effort in terms of medical technology and health care technology. it has been the v.a. so i find it interesting that on one hand, some of my colleagues tell us how terrible v.a. health care is, and on the other hand they are nervous that hundreds of thousands of veterans may want to access v.a. health care because in fact they know that it has problems, that it -- it is one of the best health care institutions in the country. does v.a. have problems? of course it has problems. i am not aware of any health care institution in america that does not have its share of problems. the difference, by the way, between v.a. and many private and nonprofit hospitals is by

law -- and it should be this way -- every problem with the v.a. health care makes it to the front pages. but my guess is, mr. president, if you have hospitals in west virginia that screw up or hospitals in vermont that screw up, they don't necessarily get into the front pages of the paper every day, but because v.a. is public and by law they have got to be forward and be transparent, they are on the front pages. in terms of advanced appropriations for v.a., my friend -- my friends on the other side have a bit of a problem with that. i don't. i find it interesting that when our republican colleagues in the house shut down the united states government because they don't like obamacare and they wanted to defund obamacare, we were seven to ten days away from preventing disabled veterans from getting the checks that they need in order to survive. so i believe that advanced

funding for the v.a. to make sure that they are never put in that position again, that there is money in the bank to pay out the benefits that we owe to our veterans in the event of another government shutdown, i think that is good public policy. as i mentioned earlier, when we talk about health care, in my view, you have got to talk about dental care as well. if people do not have adequate dental care, it impacts their employability, they are missing their front teeth. people get sick from infection ifs they don't have adequate dental care. i think we owe it to our veterans to make sure that they do. this legislation provides a pilot project for 30,000 veterans -- and we'll see how that pilot goes -- to begin to access dental care within the v.a. i suspect that we're going to see a huge need out there, and

if some of my colleagues think that veterans are not entitled to dental care, then we have a difference of opinion. that's fine. let's debate it. but i think that dental care is an intrinsic part of health care in general. i think we have a dental care crisis in the united states of america and within the dental community. and right now, as i mentioned earlier, dental care is available for those veterans who have suffered service connected -- service-connected dental problems but are not available to veterans in general, and i want to change that. now, i have heard discussion about the back log. well, every member of the senate is concerned about the backlog. we've had hearings in the senate on the backlog. and here is the story. i'm really glad that today people are concerned about the backlog. i just wonder where they were five years ago when the v.a.

before obama became president, when the v.a. was probably the largest institution in this nation, if not the world, that still did its benefits process and all of its work on paper. not digitally. what secretary of the v.a. can sector i said when he -- con sector i said -- consecki said when he became secretary is we're going to change that. we're going to change from electronic to digital system. that's what they have been doing. we have seen real progress. is it real progress? no, it is not. what the secretary has told me personally and told our committee is they are on track so that by the end of 2013, all v.a. claims will be processed within 120 days with 98% accuracy, and that's pretty good. and because of their transformation of the system -- and just think for a moment what

a huge task it is. you have individual veterans' files that are wider than this. i mean, years and years and years of records, and they are going to take all of that and put it into a digital system. that is what they are doing and they are making progress. in this legislation, we have brought forth republican ideas and democratic ideas to make sure that they are in fact on target, that they reach the very ambitious goal that secretary shinseki brought forth. so if you are interested in the claim's backlog, vote for this legislation because we have bipartisan language in it to make sure that veterans do not have to wait years to get their claims processed. my friend from oklahoma just said well, he is not sympathetic to the idea that veterans should pay in-state tuition, which is essentially what we meant when

we passed the post-9/11 g.i. educational bill. and i want to say a word on that. every time we bring forth legislation, we hear all of the reasons why we should not go forward in providing services and benefits to our veterans. i would argue and many economists would agree with me, mr. president, that one of the most significant pieces of legislation passed in the modern history of the united states of america was the g.i. bill of world war ii, and what that bill did is it said to the millions of the people who fought in world war ii, in that terrible, terrible war, that when you come home, no matter what your income is, you are going to be eligible to get a higher education, and as a result of that legislation, millions of soldiers who

returned were able to go to college, they became businessmen, they became doctors, they became lawyers, and one of the reasons that the economy of the united states of america expanded significantly for the middle class was a direct result of that very, very important g.i. bill. and what we said several years ago is we thought we should take that premise and apply it to the men and women who served post-9/11 in iraq and afghanistan, and it was a -- quite a political debate here. some of my republican friends had their doubts. we passed it. and today over one million veterans and their family members are now getting a college education. in my view, that was exactly the right thing to do, but one of the problems is -- is that people move about, veterans move about. so if they go from one state

where they have lived their whole lives -- for example, lived in vermont and they go to california, another state, and what the g.i. bill promises them is in-state tuition, it turns out that the tuition in the state that they're in now may be a lot higher than it was in their home state, and sometimes it makes it impossible for them to go to college. so we agree with virtually all of the veterans' organizations that the intent of the g.i. post-9/11 education bill was to make sure that they get in-state tuition. if somebody from california comes to vermont, they get our in-state tuition. if somebody from vermont comes to california, they get their in-state tuition. without doing that, we will deny many people who should be getting a higher education from getting that. mr. president, in our legislation, we say something that's pretty simple. previously, this congress has passed language which says that

if you served in iraq and afghanistan, you are going to get five years of free health care, and that was the right thing to do. it turns out that not everybody learned about that benefit. four or five years have come and gone. what we do is say to those veterans we're going to give you another five years to take advantage of that position. senator murray from washington, the former chair of the veterans committee who preceded me and senator reid earlier today talked about the employment situation of veterans. i think we all know that we are in a tough economy. real unemployment is close to 13%. youth unemployment is higher than that. so somebody comes home, gets out of the service, look for a job, it's a hard thing to do. i happen to believe that we have got to do what we can, a, to make sure that when people leave the service, they can find the

job and that's what this legislation does. we also want to make sure that the skills acquired by the men and women of our armed forces while they were on active duty or in the national guard become applicable to civilian life as well, and we have language in this bill that does that. there is another issue. i didn't hear my republican colleagues talking about it, but it is a very, very important part of this bill, and that is we have a situation, mr. president, where some 2,300 veterans, people who served in iraq and afghanistan, have come back with a variety of wounds which make it impossible for them to have children. and let me just give you one example of that.

a gentleman named army veteran matt kyl of colorado was wounded by sniper fire in iraq in 2007. and the sniper's round struck matt's neck, causing severe damage to a vital artery and his spinal cord. through sheer determination and with the love and resolve of his wife tracy, matt's condition improved. he and tracy began to consider having children. doctors assured them that having children could be possible with the help of in vitro fertilization. the kyl family paid more than $30,000 for reproductive treatments. in our legislation, the legislation on the floor now, we say that that's wrong. if a soldier, man or woman, was injured in war, wants to have a family, is unable to have a family, we should make it possible for them to do so. if some of my colleagues on the other side disagree, that's

fine. let's have that debate. but i think that we owe it to the 2,300 men and women who were wounded in battle to give them the opportunity to have a family. mr. president, we all know that one of the most ugly aspects of military service in recent years has been the epidemic of sexuality. when we -- sexual assault. when we send people into the military we do not want to see men and women being sexually assaulted. i know the department of defense is working hard to try to address this issue but the fact is many, many veterans who came home from war were in fact sexually assaulted. this legislation contains important provisions that would improve the delivery of care and benefits to veterans who experienced sexual trauma while serving in the military and this

language, this provision was inspired by ruth moore, who struggled for 23 years to receive v.a. disability compensation. this is a woman who was sexually assaulted, had a very difficult time proving that and getting the care that she needed. and we are in this legislation going to address that issue. madam president, in 2010, the congress took a very significant step forward in saying to family members who were caring for disable vets that we understand how terribly difficult it is, that we understand that there are wives and sisters and brothers and family members who seven days a week, 24 hours a day, are on call for veterans who have suffered serious

injuries. and that's tough. that is very tough. that is stressful. there are wives out there, sisters out there, brothers who don't get any time off, seven days a week. and what we passed is a caregiver's act that provides a modest stipend, it provides -- it provides training, it provides time off for people who are caring for veterans seven days a week. say you can have a day off. we'll send the nurse in. we did that for post-9/11 veterans. but the truth is their tens of thousands of other families who are in exactly the same experience and have been in that experience for decades. and i believe that it is appropriate that we expand the caregivers act to every generation of veterans and make sure that those families get the help that they need.

so let me conclude my remarks by saying this -- i have heard some of my republican colleagues saying that this legislation simply opens the door to every veteran in america to come in and that when they come in, the quality of care is going to be diminished. that is just a simply inaccurate statement and i hope my colleagues read the legislation before they repeat that. it's just not true. what we do do is end the absurd, coverage complicated situation of having hundreds and hundreds of different income eligibility standards so instead of many, many hundreds there will be one in each state, it will be the highest standard, that will mean that more veterans are able to come in to v.a. health care, it does not open the door and what we have been very clear about is we do

not bring more veterans in until we make sure that we have the infrastructure to deal with those veterans. and some people have said, well, you know, why do you want to bring more veterans into the v.a.? and the answer is pretty simple. i've talked to many veterans in vermont who would like to get into v.a. health care because they respect its knowledge about the needs of veterans and the high quality of care that they get, the fact that there is a very strong network of primary health care facilities all over this country which they can access. so let me just conclude for the moment by saying i appreciate very much the fact that every single member of the senate, i think it was 99 votes, voted to proceed on this debate. i look forward to this debate, it is an important debate. i look forward to serious

amendments which address the needs of veterans. but i think it would be very disrespectful to the veterans community if we started injecting into this debate totally extraneous and highly political and partisan issues. the issue of sanctions in iraq, in iran, is a very important issue. people have honest differences of opinion. that is not an issue regarding v.a. health care. it is not an issue regarding the caregivers program. it is an issue regarding dent a.m. care for our -- dental care for our veterans. let's respect veterans and at least have this debate on veterans' issues, not on extraneous political issues which will divide us. let us try to come together and not be divided. and with that madam chair, i

would yield the floor and note the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call:

a senator: madam president? the presiding officer: the senator from idaho. mr. risch: thank you, madam president. madam president, i rise today to pay tribute --.

the presiding officer: the senate is in a quorum call. mr. risch: i ask unanimous consent, madam president, the quorum call be lifted. the presiding officer: without objection. mr. risch: thank you. madam president, i rise today to pay tribute to a distinguished i.d.ian --, i.d.ian, marsha h. oglevy, the mayor of sandpoint, idaho. on january 8 she lost a valiant battle with cancer and my state lost a good friend, a champion for women and children and a tireless public servant. mayor oglevy was born at march air force base in southern california and moved to the great state of idaho in 1994. in the 20 years she made idaho her home she distinguished herself in service to others. as she once said, in many -- and many in sandpoint now say, she won the hearts and minds of the people in spientd. -- sandpoint. elected mayor just two years ago

and having served the two previous years on the city council, mayor oglevy leaves a giant hole in those hearts and in the broader community. the business and professional experience mayor ogilvy brought was wide and varied and earned her the respect of many. earlier in her career she served in restaurant and retail management when she and her husband francis arrived in sandpoint they opened a couple of small businesses, the candy cottage and all smiles, a gift shop. but marsha ogilvy was not just about business. she cared deeply about the health, welfare, and success of women and children. soon after moving to idaho, and well before entering public service she established cinderhaven, a nonprofit community organization which is dedicated to supporting children

in crisis. founded in 1996 and under the vision and compassionate care of marsha ogilvy, more than 1,300 children have found the all-important help they needed in times of their great distress so important to the sandpoint community, kinderhaven was named the grand prize winner in the 2002 governor's brightest stars awards. in decision mrs. ogilvy started women honoring women. it was designed to be a one-time event but has evolved since 1999 into an annual event to recognize and honor women in bonner county, idaho. women who are 65 or older and working to make a difference in the lives of others who love learning, exhibit qualities of leadership, marsha ogilvy recognized these qualities in others because she, too,

possessed them. all but one, she was only 64 when she passed away. if these achievements were not enough, marsha ogilvy joined with three friends to coauthor a children's book. "g.g.'s enchanted forest" was a way to honor a friend who shared their love and dedication for community service. mayor marsha ogilvie was an example of caring. her reaching out to those who volunteer is etched on the hearts of those she served in sandpoint, idaho and far beyond the city limits. may god bless her husband, her family, and the hundreds of idahoans who miss her passion,

exuberance and spirit of joy. madam president, thank you very much. i note the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call:

the presiding officer: the senator from wyoming. mr. barrasso: thank you, madam president. i ask unanimous consent the quorum call be vitiated. the presiding officer: without

objection. mr. barrasso: i ask unanimous consent to speak for 15 minutes as if in morning business. the presiding officer: without objection. mr. barrasso: thank you, madam president. late in the day on friday after reporters had gone for the weekend the obama administration quietly released its new medicare advantage payment cuts, cuts president obama wants to make to this program i believe as a doctor are potentially devastating to millions of americans. the next morning "the new york times" headline was u.s. proposes cuts to rates in payments for medicare. politicalo wrote about it -- "politico," they said the obama administration is proposing a major cut in 2015 payments for medicare advantage. 15 million americans, madam president, depend on these health insurance plans the president wants to cut. but instead of hfg to seniors and investing in a program that works very well. the obama administration is doing everything conceivable to make sure that medicare advantage fails.

back in december, the press game president obama the lie of the year award for his statement if you like your health care plan, you can keep it. millions of americans have gotten letters saying their insurance plans are canceled because of the democrats' health care law. by bye cutting medicare advantage the obama administration is now ensuring even more americans can't keep the health care plan that they like. 29% of all medicare patients have chosen to enroll in medicare advantage. there is a reason for that. the medicare advantage program lives up to its name by delivering clear advantages. the plans give extra benefits like dental corchl, vision coverage, hearing benefits, wellness programs, things important to our seniors. sometimes they offer smaller co-payments, lower deductibles, less out-of-pocket costs than the traditional medicare program does.

sometimes seniors even pay a higher monthly premium for these extra benefits but often the benefits are financed through planned savings due to the programs and the way they work. for many seniors, medicare advantage is a good option. it is the right option for them. these are people who don't have a lot of montana but who still want the -- a lot of money but who still want the peace of mind that comes with good health insurance. those seniors are now facing much higher costs or lower benefits because of the obama administration decisions rolled out last friday night. because of this proposal and the administration's way to try to sneak it out on friday, seniors are concerned and they're anxious about what the administration also is hiding. you know, ever since the president and democrats in congress passed their health care law, they've been going after seniors who rely on medicare. they raided a total of $700 billion in medicare, and we discussed that during the debate over the health care law. the money was taken from seniors

on medicare, not to strengthen medicare, not to secure the future of medicare, but to start a whole, new government program for other people. a whole new bureaucracy and it's been created by washington democrats in the health care law. obamacare specifically targeted the medicare advantage program. significant amounts of direct and indirect cuts -- payment cuts totaling over $300 million. just for this one program. so 29% of americans are seniors relying on medicare advantage because about 29% of seniors on medicare are in medicare advantage, well, they're responsible for 43% of the cuts. because of these cuts and other changes in the law, fewer -- fewer private health care plans are going to be able to participate in medicare advantage in the future.

that means a number of things. that means that some people who rely on these plans are going to find out that their plan is being canceled entirely, and some people in iowa, thousands of people in iowa have already gotten letters canceling their medicare advantage plans. the kaiser family foundation looked at what the president's health care law does to seniors, and they say that about a half a million patients will lose their existing coverage. seniors on medicare advantage. these seniors are going to have fewer options to get the care they need from the doctor that they choose at lower cost. more of these people are going to be forced into a one-size-fits-all plan. they are going to lose the insurance that worked for them. some people may find that their new insurance network doesn't include the doctors that they had before. we've seen this happening all across the country as the major provider of medicare advantage said to try to make it all work,

they had to eliminate many, many doctors from their plans so that those doctors not going to be able to keep their patients and those patients are not going to be able to keep their doctors, in spite of what the president told the american people when he looked into the camera and said, if you like your doctor, you can keep your doctor. a lot of these people imping to see their costs increase -- are going to see their costs increase. the average out-of-pocket limit for medicare advantage plans is going to increase by $464 this year. the president and washington democrats say that their health care plan was going to save people money, save people money. that's what the president told the cufnlt that' country. that's why he said he did this whole health care plan. the president told people what he wanted to hear but he failed to give them what he promised. that's why his credibility ratings are down. that's why people believe that he has misled them intentionally, and that's why this administration has viewed

-- is viewed to be incompetent by a majority of americans. turns out, costs continue to go up because of the law. this new round of cuts to medicare advantage is just another example of how the health care law is wrecking our health care system, not fixing it. america's health care system wasn't working before, but the president and the law that democrats voted for has made it worse. medicare is headed toward bankruptcy, but the administration has rejected bipartisan solutions to le refom and to strengthen the program. through cuts like the ones announced last friday, the president's health care law takes money from medicare and uses it to pay for something else. now, there was actually a double-data dump that occurred on friday. the medicare advantage cuts were announced late in the day and then later than that, the c.m.s. -- the medicare-medicaid sstleses fo

services for the country, they came out with their report and it reports that two-thirds of small businesses that provide health insurance for their employees would see their prices go up because of the health care law. two-thirds of small businesses. these are ones that by law don't have to provide health insuran insurance. employees less than 50, they don't have to by law supply. but they do often do that. they do supply that insurance. i think about 17 million people get insurance that way, through work. businesses that are not mandated to supply the insurance, but they're due to get good workers. and, as a result, what they're seeing is that their rates are going up. so that was part of the double-data durbin thadata dumpd on friday. it was interesting to see a note that came out of the democrats' lunch meeting today. it was just reported in "roll

call" magazine. a group of senate democrats are expected to launch a counteroffensive against obamacare on wednesday. a response from persistent attacks from their republican counterparts. it is what we hear at town hall meetings, it is what we hear as we travel around the country. peoples' families are noting that their families are paying less. the report in roll call says that democrats discussed the new endeavor touting benefits of the affordable care act during tuesday's weekly caucus lunch to a warm reception, according to connecticut's christopher s. murphy, who is one of the senators leading the effort. senate democrat aide said the rollout will comence with day. i welcome an opportunity to er what the democrats have to say because it is -- the damage done by this health care law to people all across the country is significant. it is interesting. all you need to do is turn to

friday's "new york times," an excellent writer for the "times" had an -- i thought ann a fascinating story. took two pages in the paper. "public sector capping part-time hours." public sector -- public sector, madam president, capping part-time hours. why? righteright here in the headlino skirt health care law. cities, counties, public schools, and community colleges around the country -- we're not talking about businesses here. we're not talking about fast-food chains. we're talking about cities, counties, public schools, and community colleges around the country have limited or reduced the hours, the workhours, of part-time employees. why? to avoid having to provide them with health insurance under the affordable care actth, state and local officials say. the cuts to public-sector

employment, which has failed to refound since the recession, though it says right here, could serve as a powerful political weapon for republican critics of the health care law who claim that it is creating a drain on the economy. well, it is creating a comain drain on the economy -- a drain on the economy, madam president. when you have two folks here in the picture in medina, ohio, working on a trash truck. one of the gentleman talks about his hours being limited to 29 hours. he called it a hit to his wallet. the president is fighting to talk about minimum wage, but actually people are losing take-home pavement it is impacting their wages, the health care law s it is impacting on how much money they take home at the end of the week. when you go over to the rest of the page, the next page, somebody who works as a clerk in the park department saw her hours drop from 38 hours to 35

hours and then to 29 hours. why? because of the health care law and the 30-hour limit. and it's interesting to go through the list. of the different jobs of people that are losing hours who want to work. these are hardworking americans who are having their hours cut, public-sector workers, people who work for cities, counties, community colleges. the list goes on -- police dispatch,substitute teachers, bus drivers, athletic coaches, school custodians, cafeteria workers and part-time professors, office clerks, sanitation workers, park inspectors, all in all people that are being hurt because of the president's health care law and the mandates and the twhai i-- andthe twhai it is put togey this president and the democrats that voted for it. it is interesting 10 see the senator from connecticut mentioned here as leading the effort. and i would recommend to him

this article by robert pear in friday's "new york times" who goes specifically to the core of what's happening in connecticut in that senator's home state. it says "mark benectad ynchts the superintendent of schools in mariden, connecticut, public school, at a board member of the men association of school distributors said in an interview that the new health care law is having "unintended consequences for school systems across the nation." this health care law is full, madam president, of unintended consequences. and now we have someone who is a board member for the american association of school administrators saying that the health care law is having unintended consequences for school systems across the nation. and he specifically says in connecticut, as in many states -- this is the article now --

"in connecticut, as in many cases, significant numbers of part-time employees work more than 30 hours a week and do not receive health benefits." now quoting the superintendent of schools in meriden, connecticut, he says, "are we supposed to lay off full-time teachers? are we supposed to lay off full-time teachers so that we can provide insurance coverage to part-time employees?" the superintendent goes on to say, "if i had to cut five reading teachers to pay for health benefits for substitute teachers," he said, "i am not sure that would be best for our students." so, madam president, i'd ask the president of the united states, what do you want? these are the choices that because of your health care law crammed down the throats of the american people you are asking the public sector of our country to make. get rid of five reading teachers in meriden, connecticut, to pay for expensive health insurance

policies for substitute teachers that that superintendent is trying to say, aim not surety that what the law requires would be best for our students. i think law was not well-thought-out, was not well-planned. so i will a be interested to see senate democrats come to the floor with their obamacare p.r. counteroffensive and explain to the -- and explain to the american people why the american people are being faced with a web site with a disastrous rollout four days after the president told the american people it will be usier to use than amazon and cheaper than your cell phone bill and you can keep your doctor if you like your doctor, why five million people then got letters from insurance companies saying they are insurance policies have been canceled, why the web site failure is just the tip of the iceberg that the american people are seeing right now in terms of premiums going up, canceled policies, can't keep their doctor, higher out-of-pocket

costs, higher co-pays, higher deductibles, all in spite of the president's glowing promises which in my opinion were made to deceive the american people in an effort to pass a health care law which many people see as bad for patients, bad for providers, and bad for the taxpayers. i am going to continue to come to the floor and talk about what i hear as i go home to wyoming each quey wee week in terms of h care law which is not providing americans what they asked for and were promised. i yield the floor. the presiding officer: the senator from illinois. mr. durbin: madam president, i want to thank my colleague, senator barrasso, for coming to the floor. noild like to give a second opinion to what he has just said. he said he wants to wait until tomorrow to hear some success stories about the affordable care act. i am going to give him a preview tonight. ray roman now ski, 62 years old,

city of chicago, musicians, part-time employee, barrel-chested guy sat next to me, patted his wallet, i've got health insurance for the first time in my life and it feels good. judy takes care of motel rooms down in southern illinois at a place that i stay. she's over there in the hospitality room. same story, 62 years old, worked every day she could and never had health insurance one day in her life. she was diagnosed with diabetes and thank god she now has, because of the affordable care act, health insurance. those are just a couple of the stories. what the senator didn't tell y you, the senator from wyoming did not tell you, is that there are aspects of this affordable care act which american families value. if you have a chile who's sick in your family with asthma maybe, diabetes, is your wife a cancer survivor? in the old days before the affordable care act, that meant it would be hard to get health insurance and if you could, it would be very expensive. so we changed it. we said you can't discriminate

against families because somebody happened to be sick. you know, those who have raised families know that that happens pretty regularly. so that protection is in the law and it's a protection which some of the absolutists want to repeal. get rid of it. let's go back to the good ole days where a sick child would basically disqualify a family from health insurance. and it used to be insurance companies had odd ways of basi basically rating people when it came to premiums. and one of the disability they identified is if the person seeking health insurance was a woman. she would discriminate against women seeking health insurance because, you know, it's possible they would become pregnant, more expensive of the well, we did away with that discrimination as well. and then there were lifetime limits. $100,000 in health insurance coverage may sound great but if you go into the hospital or the doctor the next day and you're told you have cancer and have to face radiation, chemotherapy and more, $100,000 won't ask very long and pretty soon you're into

lifing savings, and pretty soon after that you're into bankruptcy, something the presiding officer knows very well soft we eliminated the lifetime limits on health insurance policies as part of the affordable care act. i'm not hearing the senator from wyoming and others suggest they want to go back to those days, do they? the bottom line is this. the affordable care act is a good law. we wrote it and passed it without the help of any republicans. not a single one of them would step up and join us in this effort. now they've done nothing for the last four years but criticize it. i'll say this. it's not perfect. it can be improved. and i'll invite the senator from wyoming, who is a medical doctor and a man i respect, to join us in improving it. let's find a way to make it better. let's fix it. and there are things that can be fixed in the law. that's what people sent us here to do. we can give speeches about how good or bad it is but most americans want it to work. they want health insurance that's affordable and available and accessible and they want make sure that they're going to be treated fairly once they buy it.

i think the marketplaces that we'll tell you about here are working for a lot of families. and we are going to come to the floor to tell those stories. i know the other side spent a long time talking about what they consider to be shortcomings, and there are some obvious shortcomings with the affordable care out. the rollout was a disaster. anybody who says otherwise wasn't paying attention. for 60 days, we worked to get our web sites up and running and some of them still leave room to be desired -- leave room for improvement. but i talked to a businessman in chicago last week and he said, it's a good thing my business failures aren't on the front page of the paper every day because i've made a lot of mistakes. but i keep going until i get it right. that's what we ought to do. keep going until we get it absolutely right. we've got a good start trying to bring 60 million uninsured americans under protection of health insurance, to allow people to shop for the best policy for their family, and that's realistic. i also want to add one thing. the critics of the affordable care act assume that before we

passed it, health insurance premiums did not increase. we know better. particularly for those who had small businesses and individua individuals, their policies were canceled on average once every 24 months. and their health insurance premiums went up 12% to 20%. a friend of mine has a small trucking company. he tried to cover his employees who worked for him and their families until one of the employees had a sick baby and then the health insurance premiums went through the room and they all were out on their own. with the help from the employer, what he used to pay each month, they had a helping hand looking for health insurance. well, he went to buy health insurance for himself, himself, the owner of the company, and his wife and it turns out that if you turned in a claim this year for a problem you had with your foot, next year that company health insurance plan, the one he bought, wouldn't cover it, anything related to your feet. so you slowly exclude all the possible claims that can be made for profitability. and in the end, you have a

worthless health insurance policy. those were the old days. i would say to the senator from wyoming and his friends, we are not going back to the old days. we can improve this law, let's work together to do it, but we're not going back to the days of discrimination based on preexisting conditions, lifetime limits on policies, discriminations against women, excluding children from their health insurance of their families, the things that really were wrong the system. help us make it better but don't just come here and complain. i think people expect us to be more positive and constructive. madam president, at a separate part in the record, with conse consent, i rise in strong support of the comprehensive veterans health and benefits act of 2014. chairman of bernie sanders of vermont has put together a comprehensive improvement which i support. he's new as chairman but he's off to a flying start. the bill reminds us of our obligations to veterans. i especially appreciate that he worked with me on a few priorities. it has $10 million initiative on

new prosthetics and or thot i can. limb wounds is a signature wound of iraq and afghanistan. there just aren't enough professionals to treat the veterans for their injuries. now the department of veteran affairs can partner with universities to expand the number of master's degrees so our wounded warriors continue to receive the best care. the veterans' package also addresses a problem i've been working to fix that allows veterans to consolidate student loans or participate in student loan forgiveness without penalty. congress capped the interest rate for service members at 6% several years ago but a loophole has prevented service members from keeping that protection if they consolidate their student debt or enroll in the public service loan forgiveness program. this bill closes that loophole. and the bill makes sure that veterans using their g.i. bill education benefits will pay in-state tuition rates. senator sanders has a good bill here when it comes to student loans. there is one provision in it of special interest and importance

to me. several years ago one of our colleagues, the senator from new york by the way of hillary clinton, came up with a great idea. senator clinton said, we ought to help the caregivers for disabled vets. and i liked the idea a lot and was kind of envious that she came up with it first. and then she moved on to the secretary of state. so i called her at the state department and said, hillary, is it okay if i take up your bill on caregivers? and she said, be my guest, and i did. introduced the hillary clinton caregivers bill. and ultimately with the help of senator akaka and others, we passed it. and here's what it says. if you had someone who was injured after 9/11 and disabled and you were prepared to give them care, we're going to help you. for that wife who sands by her husband, husband that stands by the wife, mother or father helping the disabled vet, here's what we'll offer to you. first, the very best in skilled nursing training so that you know how to take care of your veteran and do it the right way. secondly, a respite.

two weeks out of the year, you get a vacation. we're going to send in some skilled nurses so you can go off and relax. you deserve it. after spending 50 weeks caring for this veteran. and third, if you're in a blind economically -- if you're in a bind economically, financially, we want to make sure you have enough money to survive so we offered a monthly stipend to those caregivers that are helping. let me tell you some stories that i think illustrate this so well of why it's important and why it's working. in 2005, eric edmondson was a 26-year-old army sergeant when he survived a roadside blast in iraq. he went into cardiac arrest while waiting for a transport to a military hospital and his brain was deprived of oxygen for almost 30 minutes. he became quadriplegic as a result of the injuries. the v.a. basically told eric's parents, ed and beth, that there was really no hope and no place to turn. doctors said eric would spend the rest of his life in a vegetative state and he should be sent to a nursing home. his dad said, not only no, but

hell no. this is my 26-year-old son and i'm not giving up on him. so eric was transferred to the rehab institute of chicago, which is where i first met him. his recovery was incredible. his mom and dad stayed by their son's sighted until the -- side until the day when we proudly watched eric, with a helping hand, literally walk out of the hop ihospital in his dress unifa sign of dramatic progress in just a few months. today he's living in north carolina with his wife and two children, beautiful kids. his parents are his full-time caregivers and they share the home with eric and his wife. but even these family caregive caregivers, like ed and beth, need a helping hand. they told me about hillary clinton's bill and they got me started on this. and i'm glad they did. because now that it's become the law, 12,000 families just like their as cross america are getting the helping hand of a caregiver program. it helps the veterans who from iraq and afghanistan, with their families, be where they want to be, at home, with their famili families. and if you want to get down to the bottom line, it saves the

government money. it costs a lot more money to put people in v.a. facilities than to help these families keep the veterans at home where they want to be. let me show you one other one which i think is a great story. this is a story of euri smisley who was a marine serving in afghanistan and iraq. he returned to the u.s. for what was going to be a routine surgery at a military hospital but because of complications during the surgery from an appendix procedure, he was left with a severe brain injury. amy, who is shown right here, was his fiancee at the time. and when euri reached the point where he came out in this state where he was in a wheelchair and struggling, amy said, i promised you i loved you and i'm going to marry you and we're going through with it and she did. she married euri and stood by his side. they have a beautiful daughter, adelina, who i met just a couple of weeks ago in chicago. she's four months old. it is for caregivers like amy, who dropped everything and even dropped out of school to help

care for this disabled vet, euri, that this program is designed. and i'm proud of this program. i think that the 256 -- i think that's the right number -- caregiver families in illinois have a special helping hand as they help our disabled vets. we need to expand it. bernie sanders does just that. he expands this program beyond those veterans who were afflicted after 9/11 to those who were afflicted before. from previous conflicts and previous service to our country. this caregivers program is the right thing to do. these men and women who care for our disabled vets are truly saints and angels and we ought to stand by them. giving them a helping hand through this expansion of the caregivers program is the right thing for america, it's the right thing for our vets, and it's the right thing for us to do for the men and women who risk their lives for our country. madam president, i yield the floor and suggest the absence of a quorummenquorum. a senator: madam president? the presiding officer: will the senator withhold?

the presiding officer: the senator from north carolina. mr. burr: madam president, i thank my colleague from illinois and i should have showed him -- told him that i was going to come out. let me thank him because he's raised a very important issue on caregivers and i also want to thank him for the interest he took in eric edmondson, who's from north carolina. and i might add to the story for my colleague, eric -- there wasn't a caregiver program when eric edmondson's dad took over his care. he did what i think parents have a tendency to do and he said, it can be better for my son if i take control of it. and he ended up in illinois at his dad's request. and though he hadn't made a full recovery, he's made a spectacular recovery from the prognosis, and i know my good friend from illinois has to go. but i appreciate him highlighting that. let me just say that,

madam president, i think all members of the senate would like to expand the caregivers progr program. i wrote the caregivers program. and senator akaka, then-chairman, came to the floor and it was passed. and as written, section 303, would expand the caregiver program to veterans of all eras. let me say that, veterans of all eras. we would extend the caregivers program to. if the sanders bill was passed. now, i've got the alternative bill, which is in the process of being filed. it does not expand the caregivers program. a program that i'm passionate about. i wrote it. and it doesn't do it for a reason -- and i want to turn to senator akaka's comments on the senate floor when we passed this bill. where senator akaka, the chair of the senate veterans' affairs committee, said this. "one, the needs and circumstances of the newest veterans in terms of the

injuries are different, different from those of veterans from earlier eras. two, the family situation of younger veterans is different from that of older veterans. and, three, by targeting this initiative on a specific group of veterans, the likelihood of success undertaken is enhanced." now, to me, the most important of these reasons mentioned by senator akaka was the belief that v.a. would not be able to implement a program of that manage femagnitude and that's wy caregivers was crafted to be a program that we ramped up over time and it was targeted at a very specific population and we envisioned that as v.a. got more proficient at actual training and implementing of this progr program, it would be ramped up. v.a. has proven us right. they've had trouble in implementing this program with

very limited -- in what is a very limited program. their rollout and management of the program has been flawed in several years and has been a disservice to those veterans in need of these critical services. since the start of the program 2 1/2 years ago, civil problems have been brought to my attention -- attention. these problems include decisions regarding eligibility for the program are inconsistent across the country. no quality assurance program to monitor the quality, consistency and timeliness of those decisions and no former process to appeal the decisions of eligibility for caregiver assistance. now, let me highlight the issues with this program. i want to share some stories of veterans' experiences. a veteran applied to the program at v.a. in colorado. his application was denied, yet after moving from colorado to florida, he applied again using the exact same information he

had previously submitted in colorado. the v.a. in florida granted his application. how can this happen? it's because we have got an agency that has yet to draw on the consistency needed to apply equally to our veterans. another veteran in florida suffered from multiple gunshot wounds resulting in pair pledge allegiance yeah. v.a. denied him -- resulting in becoming a paraplegic. v.a. denied him entry because he did not require assistance with at least one of daily living or a.d.l. because he was being compensated through aid in assistance or a. and a. program, i find it interesting this veteran did not qualify for caregivers because he was actually compensated under the aid and assistance program because what he needs is a.d.l. services, not just the one required under the caregiver program. in addition, i have also heard

many veterans and their caregivers are treated rudely by the v.a. staff applying these programs for ptsd diagnosis. these staff have told them that ptsd, get this, ptsd is not a disability that requires assistance with a.d.l.'s or activities of daily living. assistance with the activities of daily living is only one of the four criteria needed as having a serious injury and under the law a veteran needs to meet one of the four. even the appeals process does not seem to be well thought through. you see, madam president, we can write the laws, but it's the agency's regulations that they write that dictate how these programs are run. and v.a. says that they have an appeals process, however it's vastly different than the appeals process at v.b.a., the

veterans benefit administration. it leaves veteran service officers or v.s.o.'s at a disadvantage to help veterans and their caregivers. v.s.o.'s have been told the v.a. considers it a medical decision and they cannot, cannot question the denial. the only recourse these veterans and their caregivers have is to appeal to the medical center director. the problem with this, it was a medical center director who denied the appeal in the first place. now, i'm going to go on as the days go on describing the things in this program that we would all like to embrace, things that i think every member of the senate says we ought to do this for veterans. here's the problem. if we have got a broken system jamming more people into it is actually the worse thing we can do. as i said earlier, there is nothing in the sanders bill to fix the things that are broken at v.a. there is nothing in the alternative bill to fix things in the v.a., but the one thing that i don't do in the

alternative bill is i don't jam millions of more veterans into the system. caregivers should be expanded as vapor fects how to implement it, educate the caregivers, be able to address the concerns and more importantly the intent of why we wrote the program. enrollment or access to v.a. should only open up if we have got the health care professionals or the facilities to handle them but not to crowd out those current veterans who leave the battlefield today and need the services that only the v.a. can provide. so although in everybody's wish list we'd like to expand every veteran, in the caregiver program, we'd like to expand to everybody who wants to care for a loved one. the truth is we do the ones that are in the system an injustice if we are not prepared to be able to implement it, to handle it, and that's the difference

between the sanders bill and my alternative. we simply look at the things that have bipartisan support but don't necessarily grow the problem worse than it is today. i said earlier, my redwret -- and i see -- regret -- and i see my colleague from south carolina here -- my regret on this debate is we're not here on the senate floor debating reforms to the veterans administration because i think the president would agree these are areas that don't have a partisan leaning. when we look at our nation's veterans, we don't see one side of the aisle or the other. we see a promise we made to them and a commitment we've got to fulfill. to ignore the things that need reforming really is a mistake. to talk about expanding the population without reforming those areas quite frankly is disingenuous to the veterans we owe so much to.

and with that, i would yield the floor. the presiding officer: the senator from south carolina. mr. graham: thank you, madam president. i would like to speak for 15 minutes, i believe. the presiding officer: without objection. mr. graham: one, i would like to compliment senator burr for trying to find a way to improve veterans' health care, and i think that the comment he made is pretty accurate. before you expand the system that's fairly broken, it looks to me like you would want to fix it, and there is a bipartisan view that it is broken and a lot of solutions have bipartisan support, but we are where we are, and i know senator sanders is very genuine about wanting to expand veterans' benefits, and i certainly understand where senator burr is coming from, that we want to, one, pay for whatever we do because we're $17 trillion in debt, but two, that we have got to look at the broken system. if you include another

14 million veterans, people who are not service connected, make them overnight eligible for the v.a. health care that is in short supply, you will frustrate the ones who need it the most and take a weak system and completely break it. it seems to me that's not helping veterans at all. but part of the package that senator burr has authored also deals with another problem of great and immediate concern -- imposing sanctions on the iranian nuclear program if the negotiations fail to deliver the desired result. now, this is an unfortunate moment for me. senator menendez and kirk have been a team for a long time, working to impose sanctions on the iranian government as they march toward a nuclear weapon.

we have imposed 16 rounds of sanctions since 1987, nine u.n. security council resolutions since 2006, demanding the full and sustained suspension of all uranium enrichment related and reprocessing activities in its full cooperation with the iaea. this body has been bipartisan when it comes to the iranian nuclear program and our support for israel. senator menendez has been one of the leading voices in the entire congress. he deserves a lot of credit. he is my friend. we have a new round of sanctions that are bipartisan. we have 17 democratic cosponsors, all but two republicans, 59 cosponsors that would allow tankses to be available and in place if we do not reach a final deal in this round of negotiations in the b-5-plus one. why is it important that the congress reimpose sanctions

through new legislation if there is failure? number one, the sanctions are designed to get the end game right, and our belief that the only successful outcome through negotiations would be to dismantle the plutonium producing reactor. the iranians do not need a plutonium producing reactor for the nuclear power program. to comply with the provision that requires the removal of all highly enriched uranium, a lot of highly enriched uranium is now in the hands of the iranian government, and the u.n., of all bodies, has asked for it to be removed and turned over to the international community. i worry that if you leave this highly enriched uranium in place in iran, we will live to regret it. a dirty become becomes a real possibility. and the other aspect of a final deal that has to be accomplished, in my view, is that the iranian regime should

be of the enrichment business. there are 15 nations that have nuclear power programs that do not enrich uranium. mexico and canada are two of those nations. we're objecting to the south koreans who want to go into the enrichment business. i don't mind south korea having a nuclear power program, but we really have to watch the spread of nuclear proliferation through the enrichment of uranium. it is imminently possible to have a nuclear power program and have the fuel cycle controlled. you don't need to enrich to have commercial nuclear power. and if you were going to make a list of countries that are unreliable and dangerous and you would not want to give the right to enrich, i think iran would be at the top. just look at how this regime has behaved over the last 30 years. i don't have time to go into all the list of horribles, but our resolutions regarding the iranian nuclear program lists them very well. so we're at an impasse now. the republican position is that

we should have a new sanctions vote on the bipartisan sanctions bill now while the negotiations are going on to reinforce to the international community that we're very serious about pressure being applied to the iranians until we get the deal that we all can live with. i think it is fair to say that the iranians would not be in negotiations without crippling sanctions. i want to give credit to the obama administration for implementing a sanctions regime that really did cripple the iranian economy and it's gotten them to the table. unfortunately, the interim deal has absolutely undercut all of our gains, and i will give you some details as to why all we have accomplished has been undercut and the sanctions regime that got the iranians to the table is crumbling before our eyes o here is what our allies in israel say, the prime

minister of israel said -- "iran got the deal of the center, and the -- century, and the international community got a bad deal." i think he is absolutely right. under the interim deal, not one ounce of highly enriched uranium is required to be taken out of iran. some of it would be chemically altered, and you can reverse that chemical process so that it could be processed for weapons used later down the road. not one centrifuge has been destroyed. of the 16,000 to 18,000 centrifuges, not one has been destroyed. the plutonium producing reactor is not being dismantled. it is being moth-balled for lack of a better word, and i'm not so sure it's even in a mothball status. so the prime minister of israel says iran got the deal of the century and the international community got a bad deal. again, i would agree. nothing has been accomplished in the interim deal.

the interim deal is so far away from a final deal, i don't see how you can get there. you know, we have to dismantle the plutonium reactor completely, not just stop its construction or delay its construction. we should remove all the highly enriched uranium out of the hands of the ayatollah because it's too dangerous to leave it there and the u.n. agrees with that. that's their position. if the u.n. wants a nuclear power program, i would say that's fine. build a reactor in iran. build a couple reactors. help the russians. help the russians construct their reactor as long as the international community can control the fuel cycle. there is no need to enrich in iran for a peaceful nuclear power program, and we would be crazy as a nation and a world to give this regime the right to enrich uranium

do you believe the iranians have been trying to build a 30 bomb rather than a nuclear power program, it's clear they've been trying to build a nuclear bomb and get right up to the edge. they have one of the most sophisticated enrichment programs in the world and i don't think it's designed to produce peaceful nuclear power. here's what the head of iran's nuclear agency said last month. the iceberg of sanctions is melting while our centrifuges are still working. this is our greatest achievement. he's right. what more can i say? the head of the iranian nuclear agency said on iranian state television the iceberg of sanctions is melting while our centrifuges are also still working. this is our greatest achievement. this is what the foreign minister said. the white house tries to betray

it as basically as dismantling of iran's nuclear program. we're not dismantling any centrifuges, any equipment. we're simply not producing, not enriching over 5%. they're telling us and the world this interim deal they're not dismantling a damn thing. president rohany, the new moderate -- if you believe that, i've got property to sell you. said on ?b cnn -- cnn there will be no destruction of centrifuges. no, no, not at all. if you believe as i they should be out of the enrichment business all the centrifuges should be destroyed because to allow this regime to continue to enrich i think is dangerous and quite, frankly, will lead to a military conflict between israel and iran and maybe others. president